638 Major Neonatal Congenital Heart Disease in Ireland is Increased in Incidence and Complexity Compared to International Figures

Abstract

Background and aims: The importance of ultrasound screening for major congenital heart disease(MCHD) is well established. In the Republic of Ireland termination of pregnancy for fetal abnormality is legally prohibited. Screening for congenital cardiac abnormality is offered in tertiary obstetric units but is not universally available. The study aimed to assess incidence of MCHD particularly of four chamber lesions in this context.Methods: In 2009 115 term infants were admitted to the National Children's Heart Centre in Our Lady's Children's Hospital in Dublin with MCHD defined as duct dependent lesions or lesions requiring surgery in the first 6 weeks of life. Their lesions were coded using the paediatric European Coding system and the diagnoses compared with EUROCAT (European Surveillance of Congenital Anomalies) data. Preterm infants and infants who were admitted outside the 6 week window were excluded.Results: There were 75,720 live births in Ireland in 2009, of these 115 infants had MCHD. Of these 44(21%) had their diagnoses made antenatally. No patient with an antenatal diagnosis had a termination of pregnancy. The incidence of congenital heart disease in Irish newborns was significantly elevated for hypoplastic left and right heart, coarctation and pulmonary atresia.Conclusion: Irish rates of antenatal diagnosis compare poorly with Europe. The severity and complexity of cardiac disease in Irish neonates is increased resulting in an increased demand on neonatal cardiac and cardiothoracic surgery services.